Yes, the anti-vaccine fiction and deception are one of the greatest dangers to the world’s public health. Their tropes, memes, and falsehoods are convincing enough people to delay or avoid vaccinating their children that diseases we thought weren’t a threat anymore are coming back. Europe and the USA are experiencing an unprecedented measles outbreak because of slightly lower measles immunization rates.

Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the USA. There are more than 40 HPV sub-types that can infect the genital areas of males and females. Additionally, some HPV types can also infect the mouth and throat. HPV is generally transmitted from personal contact during vaginal, anal or oral sex.

HPV is linked to cancers in men and women, and because there are so many subtypes, research has established which HPV types are related to which cancers. Because HPV is sexually transmitted, most of the infections occur near the mouth, throat, anus and genital areas–and most HPV related cancers begin there.

HPV is believed to cause nearly 5% of all new cancers across the world, making it almost as dangerous with regards to cancer as tobacco. According to the CDC, roughly 79 million Americans are infected with HPV–approximately 14 million Americans contract HPV every year. Most individuals don’t even know they have the infection until the onset of cancer. About 27,000 HPV-related cancers are diagnosed in the USA every year.

I am a huge fan of the zombie horror movies, ever since being dragged to see George A Romero’s original and iconic Night of the Living Dead black and white movie while in graduate school. The worst part of my experience of that movie is that my apartment backed up to the largest and oldest cemetery in the city (containing a history of the city going back to the early 1800’s). I believe I’ve seen literally hundreds of zombie movies since then, watching some awfully lousy junk along with some interesting takes on the zombie genre.

There are lots of reasons why I enjoy the zombie movies. The dystopian, post-apocalyptic futures are interesting to comprehend. The director’s viewpoints on how humanity reacts in response to the zombie infested world is also great. And there’s always humor in watching characters do things that we all know will get them killed because, irony of ironies, they don’t appear to have watched zombie movies to avoid dumb situations. Like riding on your horse down the middle of the street in one of the largest cities in the country soon after the outbreak. Seriously? Continue reading “World War Z is not going to be popular with the vaccine deniers”

I was going to put some snarky comment in the title like, “but wait, what about the statistics.” Because we know that this isn’t a good decision, and that the vaccine deniers will be all over it like Mr. Andy Wakefield’sfraudulent and retracted study claiming that vaccines cause autism. But let’s move on to what happened.

The health ministry decided June 14 to withdraw its recommendation for a vaccination to protect girls against cervical cancer after hundreds complained about possible side effects, including long-term pain and numbness.

The Ministry of Health, Labor and Welfare is not suspending the use of the vaccination, but it has instructed local governments not to promote the use of the medicine while studies are conducted on the matter.

So far, an estimated 3.28 million people have received the vaccination. However, 1,968 cases of possible side effects, including body pain, have been reported.

The ministry’s task force discussed 43 of those cases. However, a cause-and-effect relationship between the vaccination and the pain and numbness could not be established, so the task force members called for further studies by the ministry.

The ministry’s investigation is expected to take several months. It will then decide whether to reinstate or continue to withhold its recommendation for the vaccination.

So, the health ministry is going to withhold recommendation of the HPV vaccination because they notice 43 cases for which they couldn’t establish a causal relationship to the vaccine. In other words, 0.0013% of cases, a number so small that it’s pretty close to impossible to affix any statistical significance to it. In fact, random background “noise” (that is that some whole body pain could be expected in any random sampling of vaccinated or unvaccinated individuals) of this type of observation is as plausible as correlation (let alone causation) to the vaccine. In fact, the Health Ministry failed to provide us with data concerning the level of these side effects in the general population. Nor how soon after vaccination. Nor anything potentially useful in a scientific analysis.

What’s worse is that, according to the same article, about 2700 women in Japan die every year from HPV related cancers. So, because of complaints from the antivaccination lunatics in Japan (didn’t know they had any, but I shouldn’t be surprised), and bad statistics (43 potential cases of “body pain” out of 3,280,000 vaccinations), the Health Ministry stops recommending the vaccine. Exactly what were these people thinking?

Finally, let’s be clear here. The vaccine hasn’t been pulled from the market nor has it been outlawed; teenagers can still get the vaccine. And this was a very unusual move, since only 3 years ago, Japan’s parliament added the HPV vaccine to the mandatory schedule. Hopefully, this committee will look at the numbers from a statistical and scientific point of view and fix this stupidity.

For those of you who track these things, this past week is World Immunization Week, an annual awareness campaign for immunizations worldwide sponsored by the World Health Organization. As part of of their efforts to increase awareness of the need to vaccinate worldwide, they put together an online question and answer session last week in an attempt to debunk some of the myths surrounding vaccinations. In other words, some of the greatest minds in worldwide healthcare issues, including infectious diseases and vaccinations, answered and debunked some of the craziest myths about vaccines across the world.

The Centers for Disease Control and Prevention, commonly known as the CDC, this week published Progress in Global Measles Control, 2001-2010. In 1980, there were over 2.6 million deaths worldwide from the measles virus. Though measles is considered by many people as innocuous, it is, in fact, a relatively dangerous infection with a variable prognosis. For vast majority of sufferers, there are few complications, but for some, even healthy individuals, it can be debilitating or even fatal. Notwithstanding, I have always wondered why the anti-vaccination gang is willing to risk the possible death of their children by refusing to inoculate them, in light of very few risks or side effects of the vaccination itself. I digress.

Immunization prevents an estimated 2.5 million deaths every year. Immunization prevents deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles. It is one of the most successful and cost-effective public health interventions.

More children than ever are being reached with immunization. In 2010, an estimated 109 million children under the age of one were vaccinated with three doses of diphtheria-tetanus-pertussis (DTP3) vaccine. These children are protected against infectious diseases that can have serious consequences like illness, disability or death.

An estimated 19.3 million children under the age of one did not receive DTP3 vaccine. Seventy percent of these children live in ten countries, and more than half of them live in WHO’s Africa and South-East Asia regions.

Over 1 million infants and young children die every year from pneumococcal disease and rotavirus diarrhea. A large number of these deaths can be prevented through vaccination.

Public-private partnerships facilitate the development and introduction of vaccines. For example, a new vaccine which prevents the primary cause of epidemic meningitis in sub-Saharan Africa, meningococcal A, MenAfriVac, was introduced in Burkina Faso, Mali and Niger last year. At the end of 2011. Cameroon, Chad and Nigeria are vaccinating more than 22 million individuals with the vaccine which has the potential to eliminate the leading cause of meningitis epidemics in Africa.

The supply of influenza vaccines has been significantly expanded. The expansion has been possible as a result of WHO supporting the efforts of vaccine manufacturers to produce and license influenza vaccines in 11 developing countries.

Global measles mortality has declined by 78%. Global measles mortality has been reduced from an estimated 733 000 deaths in 2000 to 164 000 deaths in 2008, thanks to intensified vaccination campaigns.

Polio incidence has been reduced by 99%. Since 1988, polio incidence has fallen by 99%, from more than 350 000 cases to 1410 cases in 2010. Only four countries remain endemic – Afghanistan, India, Nigeria and Pakistan – down from more than 125 countries in 1988.

Annual deaths from neonatal tetanus have fallen. Neonatal tetanus deaths have declined to an estimated 59 000, down from 790 000 deaths in 1988.

Immunization provides an opportunity to deliver other life-saving measures. Immunization not only protects children from vaccine-preventable diseases. It also serves as an opportunity to deliver other life-saving measures, such as vitamin A supplements to prevent malnutrition, insecticide-treated nets for protection against malaria and deworming medicine for intestinal worms. In addition, the benefits of immunization are increasingly being extended across the life course to include adolescents and adults, providing protection against life-threatening diseases such as influenza, meningitis, and cancers that occur in adulthood.

Has there been a more successful human medical effort in the history of man? No.

Also, because of low patient compliance, misdiagnosis, and other issues, multi-drug resistant (MDR) and extensively drug-resistant (XDR) versions of TB can arise in a population. MDR is resistant to the first-choice drugs, requiring treatment with a larger cocktail of one or more of the nine different “second-line” antibiotics, which are less effective, have more adverse effects, and can take much longer to effect a cure, up to 2 years or more. XDR TB is resistant to the three first-line drugs and several of the nine antibiotics usually considered as second line choices.

As the article states:

The vast majority of these unfortunate patients seek care from private physicians in a desperate attempt to find a cure for their tuberculosis. This sector of private-sector physicians in India is among the largest in the world and these physicians are unregulated both in terms of prescribing practice and qualifications. A study that we conducted in Mumbai showed that only 5 of 106 private practitioners practicing in a crowded area called Dharavi could prescribe a correct prescription for a hypothetical patient with MDR tuberculosis. The majority of prescriptions were inappropriate and would only have served to further amplify resistance, converting MDR tuberculosis to XDR tuberculosis and TDR tuberculosis.

Right now, the infection seems to be in a small subgroup of TB patients in India (and Iran) in a border region that has poor medical care. However, given the lack of effective antibiotics means that we’re all in this together.

The interesting fact about the title of the article–the authors seem to have invented a new subset of TB, Totally Drug Resistant.

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